Roberta Ramirez

Managed claims processing, eligibility verification, and benefit determinations for Social Security beneficiaries.

• Conducted detailed investigations of claims to verify coverage and eligibility.
• Assisted clients in establishing entitlement to benefits, ensuring compliance with SSA policies.
• Utilized SSA computer systems to access, update, and verify claimant information.
• Assisted with filing appeals on denied claims with insurance companies.
• Communicated with other departments to establish action plans and manage open claims to closure.
• Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
• Developed training materials for staff members on best practices for handling different types of claims.
• Precisely calculated refunds, premiums, and adjustments.
• Planned and conducted investigations of claims to confirm coverage and compensability.
• Provided customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
• Organized information by using spreadsheets, databases or word processing applications.
• Examined claims, records and procedures to grant approval of coverage.
• Advised management on potential changes needed in policies or procedures based on findings from investigations.
• Documented all claim activities in a clear and concise manner.
• Provided exceptional customer service to maintain positive relationships with all parties.
• Researched medical records to evaluate claim validity

• Resolved discrepancies and made final decisions on initial and ongoing benefits, maintaining accuracy and timeliness.

Provided technical support and training to staff and clients, supporting system development and policy adherence.

• Developed and coordinated monthly training sessions on SSA policies and procedures.
• Facilitated communication between technical and non-technical stakeholders.
• Resolved customer complaints via phone or email in a timely manner.
• Supported system development efforts to improve departmental workflows.
• Answered inquiries from internal and external customers, providing expert guidance on SSA systems and policies.
• Monitored employee productivity and provided coaching to enhance performance
• Improved and refined methods, process steps or procedures and implemented changes.
• Provided technical support and troubleshooting assistance to team members and clients.
• Completed day-to-day duties accurately and efficiently.
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service
• Assisted in the preparation and delivery of technical training sessions.
• Diagnosed computer problems using diagnostic tests and troubleshooting techniques.
• Compiled and analyzed technical data for project reports and presentations.
• Participated in meetings, providing technical insights and updates.

Delivered frontline customer support, resolving inquiries and issues related to social security services.

• Provided knowledgeable assistance to the public via phone and email, resolving a wide range of inquiries.
• Asked probing questions to determine service needs and accurately input information into electronic systems.
• Performed administrative tasks such as filing paperwork, updating databases and generating reports.
• Answered customer inquiries and provided accurate information regarding products and services.
• Developed positive relationships with customers through friendly interactions.
• Updated databases with new and modified customer data.
• Presented existing and prospective customers with valuable service or product information to aid in decision-making.
• Conducted regular follow-up calls with customers after resolving their issues.
• Maintained a high level of professionalism when dealing with difficult customers.
• Increased customer satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly.
• Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
• Maintained professionalism and composure in stressful situations, ensuring positive customer interactions.

• Investigated and resolved client issues, enhancing satisfaction and trust.

• Recognized by management for providing exceptional customer service.
• Answered customer questions and provided store information.
• Provided excellent customer service while promoting loyalty programs to increase sales potential.
• Kept check-out areas clean, organized and well-stocked to maintain attractive store.
• Greeted customers and answered any questions they had about the store's products and services.
• Processed sales transactions to prevent long customer wait times.
• Assisted customers over the phone regarding store operations, product information and order placement.
• Scanned merchandise using point-of-sale system for accurate purchase totals.
• Processed returned merchandise by strictly following store return and exchange procedures.
• Answered customer inquiries regarding store policies and procedures.
• Trained new team members in cash register operation, stock procedures, and customer services.
• Answered phone calls to assist customers with questions and orders.
• Maintained work area and kept cash drawer organized.
• Welcomed customers, offering assistance to help find store items.
• Followed company security procedures for handling large sums of money.
• Counted money in cash drawers at the beginning of shifts to ensure amounts were correct.
• Accepted cash and credit card payments, issued receipts and provided change.
• Processed credit card, cash, and check payments, ensuring all transactions were accurate.
• Completed daily recovery tasks to keep areas clean and neat for maximum productivity.
• Worked closely with front-end staff to assist customers.
• Resolved customer complaints professionally in accordance with company policy.
• Issued receipts, refunds, credits or change due to customers.